Neurologic impact of atrial fibrillation.

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI:10.1097/HCO.0000000000001093
Daniel R Feldman, Emily P Zeitler
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Abstract

Purpose of review: Cognitive dysfunction is a complex condition that is becoming increasingly more prevalent. There has been growing acknowledgement that individuals with atrial fibrillation are at an increased risk of cognitive dysfunction beyond the association of age with both disorders. The purpose of this review is to explore the potential underlying mechanisms connecting atrial fibrillation and cognitive dysfunction and to examine the existing evidence for potential treatment options.

Recent findings: Many mechanisms have been proposed for the association between cognitive dysfunction and atrial fibrillation. These include cerebral infarction (both micro and macro embolic events), cerebral microbleeds including those secondary to therapeutic anticoagulation, an increased inflammatory state, cerebral hypoperfusion, and a genetic predisposition to both diseases. Treatments designed to target each of these mechanisms have led to mixed results and there are no specific interventions that have definitively led to a reduction in the incidence of cognitive dysfunction.

Summary: The relationship between cognitive dysfunction and atrial fibrillation remains poorly understood. Standard of care currently focuses on reducing risk factors, managing stroke risk, and maintaining sinus rhythm in appropriately selected patients. Further work needs to be conducted in this area to limit the progression of cognitive dysfunction in patients with atrial fibrillation.

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心房颤动对神经系统的影响。
回顾的目的:认知功能障碍是一种日益普遍的复杂疾病。越来越多的人认识到,除了年龄与认知功能障碍的关系外,心房颤动患者患认知功能障碍的风险也在增加。本综述旨在探讨心房颤动与认知功能障碍之间的潜在内在机制,并研究潜在治疗方案的现有证据:认知功能障碍与心房颤动之间的关联有许多机制。这些机制包括脑梗塞(微栓塞和大栓塞事件)、脑微出血(包括治疗性抗凝继发出血)、炎症状态加重、脑灌注不足以及这两种疾病的遗传易感性。针对上述每种机制的治疗结果不一,目前还没有特定的干预措施能明确降低认知功能障碍的发病率。摘要:人们对认知功能障碍与心房颤动之间的关系仍然知之甚少。目前的标准治疗重点是减少风险因素、控制中风风险以及在适当选择的患者中维持窦性心律。要限制心房颤动患者认知功能障碍的发展,还需要在这一领域开展进一步的工作。
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来源期刊
Current Opinion in Cardiology
Current Opinion in Cardiology 医学-心血管系统
CiteScore
4.20
自引率
4.30%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.
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